Are networks for residual language function and recovery consistent across aphasic patients?
Are networks for residual language function and recovery consistent across aphasic patients?
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DOI：
10.1212/wnl.0b013e31821a44c1
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发表时间：
2011-05-01
期刊：
影响因子：
9.9
通讯作者：
Hamilton, Roy H.
中科院分区：
文献类型：
--
作者：
Turkeltaub, Peter E.;Messing, Samuel;Hamilton, Roy H.
目的：如果失语症的神经可塑性改变在所有研究中是一致的，这将意味着相对刻板的恢复机制，可以指导设计更有效的非侵入性脑刺激治疗。为了解决这个问题，我们对中风后慢性失语症的功能神经影像学研究进行了荟萃分析。方法：收集脑卒中后慢性失语症患者（n = 105）和对照组（n = 129）使用语言任务的功能神经影像学文章。激活可能性估计荟萃分析确定了每组一致的活动区域。通过确定失语患者和对照组在相同的实验条件下是否激活来评估失语患者和对照组招募的区域之间的功能同源性。结果：控制组持续激活左半球语言区网络。失语症患者持续激活与对照组语言网络同位的左半球语言节点、左半球新区域和右半球区域。有左侧额下回病变的患者比没有左侧额下回病变的患者更可靠地恢复了右侧额下回。一些区域，包括右背包部，与相应的控制区域功能同源，而其他区域，包括右三角部，则不是。结论：失语症患者的语言功能的脑区网络在研究中是基本一致的。有几种恢复机制，包括备用淋巴结的持续功能，备用淋巴结的代偿性恢复，以及可能阻碍恢复的区域的恢复。这些发现可能会指导大脑刺激方案的发展，这些方案可以应用于具有共同特征的失语症患者群体。神经病学(R) 2011；76:1726 - 1734
Objectives: If neuroplastic changes in aphasia are consistent across studies, this would imply relatively stereotyped mechanisms of recovery which could guide the design of more efficient noninvasive brain stimulation treatments. To address this question, we performed a metaanalysis of functional neuroimaging studies of chronic aphasia after stroke.Methods: Functional neuroimaging articles using language tasks in patients with chronic aphasia after stroke (n = 105) and control subjects (n = 129) were collected. Activation likelihood estimation meta-analysis determined areas of consistent activity in each group. Functional homology between areas recruited by aphasic patients and controls was assessed by determining whether they activated under the same experimental conditions.Results: Controls consistently activated a network of left hemisphere language areas. Aphasic patients consistently activated some spared left hemisphere language nodes, new left hemisphere areas, and right hemisphere areas homotopic to the control subjects' language network. Patients with left inferior frontal lesions recruited right inferior frontal gyrus more reliably than those without. Some areas, including right dorsal pars opercularis, were functionally homologous with corresponding control areas, while others, including right pars triangularis, were not.Conclusions: The network of brain areas aphasic patients recruit for language functions is largely consistent across studies. Several recruitment mechanisms occur, including persistent function in spared nodes, compensatory recruitment of alternate nodes, and recruitment of areas that may hinder recovery. These findings may guide development of brain stimulation protocols that can be applied across populations of aphasic patients who share common attributes. Neurology (R) 2011;76:1726-1734